The effect of isoflurane anesthesia on the electroencephalogram assessed by harmonic wavelet bicoherence-based indices.

Bicoherence quantifies the degree of quadratic phase coupling among different frequency components within a signal. Previous studies, using Fourier-based methods of bicoherence calculation (FBIC), have demonstrated that electroencephalographic bicoherence can be related to the end-tidal concentration of inhaled anesthetic drugs. However, FBIC methods require excessively long sections of the encephalogram. This problem might be overcome by the use of wavelet-based methods. In this study, we compare FBIC and a recently developed wavelet bicoherence (WBIC) method as a tool to quantify the effect of isoflurane on the electroencephalogram. We analyzed a set of previously published electroencephalographic data, obtained from 29 patients who underwent elective abdominal surgery under isoflurane general anesthesia combined with epidural anesthesia. Nine potential indices of the electroencephalographic anesthetic effect were obtained from the WBIC and FBIC techniques. The relationship between each index and end-tidal concentrations of isoflurane was evaluated using correlation coefficients (r), the inter-individual variations (CV) of index values, the coefficient of determination (R(2)) of the PKPD models and the prediction probability (P(K)). The WBIC-based indices tracked anesthetic effects better than the traditional FBIC-based ones. The DiagBic_En index (derived from the Shannon entropy of the diagonal bicoherence values) performed best [r = 0.79 (0.66-0.92), CV = 0.08 (0.05-0.12), R(2) = 0.80 (0.75-0.85), P(K) = 0.79 (0.75-0.83)]. Short data segments of ∼10-30 s were sufficient to reliably calculate the indices of WBIC. The wavelet-based bicoherence has advantages over the traditional Fourier-based bicoherence in analyzing volatile anesthetic effects on the electroencephalogram.